Request for PSA

This form is intended to initiate a Professional Service Agreement (PSA) with an independent contractor, to be paid for by any sponsored project, for services that cost more than $2,000.00.

The information entered into this form will be sent to the Office of Sponsored Programs, and will be vetted against the funding source that is provided. Some situations may require an internal rebudget, and/or sponsor approval, in which case OSP will contact you outside of this form.

In order for WPI to issue payment, any and all consultants must be added to Workday as a “Supplier”. No consultant will receive payment from a PSA prior to being a verified “Supplier” in Workday.

WPI uses AdobeSign to circulate the PSA for review and signature. You do not need an account in order to sign. When providing email addresses below, please make sure they are regularly monitored.

If you have any questions about this form (e.g. is it necessary, how to fill it out, what happens after you submit, etc.), please contact Katelyn Turnbull (kturnbull@wpi.edu).

PROJECT INFORMATION

PI Name: *

E-mail: *

Project Title: *

Grant Worktag or AWD number: *

Sponsor: *

Sponsor Type: *

CONSULTANT COMPENSATION DETAILS

Contract Start: * +

Contract End: * +

Total Obligated Dollars for Contract Period: *

Please download and fill out the Vendor Selection form and upload below when finished.

Vendor Selection Form: *

How will the consultant be paid? *

Hourly

By Deliverable(s)

Hourly Rate: *

Describe in detail the schedule of all deliverables, being sure to include fixed dollar amounts per deliverable and delivery dates: *

Consultant Quote/SOW/Deliverable Schedule:

CONSULTANT INFORMATION

Name of Contractor (as listed on W-9): *

E-mail: *

Phone Number: *

Full Mailing Address: *

POC for any/all contract negotiations: *

Currently, what country are you physically present in? *

*

By providing the information requested in this form, you are consenting to WPI’s use of the provided information for the purpose for which the form is being used. See Privacy Policy Below.